Few details of the clinical features of hepatocellular carcinoma (HCC) developing extrahepatic recurrence after a curative resection have been published. The purpose of this study was to clarify the clinicopathologic findings of patients with HCC who experienced extrahepatic metastases. Clinicopathologic data were available for 119 patients who underwent an R0 resection for HCC. Twenty-three patients who developed extrahepatic metastases during the follow-up period were compared with the patients who remained free from recurrence for at least 5 years after resection ( n = 21) or with only intrahepatic recurrences ( n = 75). Patients with extrahepatic recurrences were more likely to have their tumor macro- or microscopically invading the tumor capsule ( P < 0.001) and hepatic vein ( P = 0.003), a high AFP concentration ( P = 0.014), and advanced TNM stage ( P = 0.006) than the other patients. As for treatment-related variables, inflow vessel occlusion during hepatectomy was less frequently associated with extrahepatic recurrences than if it were not performed ( P < 0.001). By multivariate analysis, absence of tumor invasion to the capsule (relative risk [RR] = 0.080; P = 0.023) or to the hepatic vein (RR = 0.108; P = 0.014) and a hepatectomy in which inflow vessel occlusions were performed (RR = 0.161; P = 0.004) were selected as independent factors for reducing extrahepatic recurrences after a hepatectomy. In HCC patients, the control of intrahepatic recurrences and extrahepatic recurrences after a hepatectomy is important to improve the prognosis. Inflow occlusion during the hepatectomy may reduce HCC metastases to extrahepatic sites.

Background. Sorafenib is amolecular-targeted therapy used in palliative treatment of advanced hepatocellular carcinoma in Child A patients. Aims. To address the question of sorafenib as neoadjuvant treatment. Methods. We describe the cases of 2 patients who had surgery after sorafenib. Results....

Purpose: The clinical significance of the surgical resection of metastatic lymph nodes (LN) from patients with hepatocellular carcinoma (HCC) remains controversial. The aim of this study was to evaluate the significance of the surgical resection of LN metastasis of HCC. Methods: Among 961...

This study was conducted to evaluate the safety and efficacy of liver resection in patients with hepatic metastases from renal cell carcinoma and to identify selection criteria for patients suitable for resection. Between January 1988 and March 2006, 31 patients underwent liver resection for...

We studied the pattern of intrahepatic micrometastases using large pathologic sections on liver resection specimens with ample resection margins from 113 patients with a solitary hepatocellular carcinoma (HCC). The liver tissues around the HCC were divided into proximal and distal areas...

Peritoneal implantation from hepatocellular carcinoma (HCC) after hepatic resection is infrequent, and information on risk factors and long-term survival of such patients is lacking. The clinicopathologic features and risk factors of 16 HCC patients after hepatic resection who developed...

Background: The prognosis of advanced hepatocellular carcinoma (HCC) remains poor, particularly in patients with tumor thrombi (TT) in the major vessels. Patients and Methods: From July 1992 to October 2004, 161 patients diagnosed as having advanced HCC with major vascular involvement were seen...

Background: The management of hepatocellular carcinoma (HCC) in patients with concomitant esophageal varices (EV) remains controversial. We assessed the surgical outcome of hepatectomy and aimed to clarify the indications and management of HCC in patients with concomitant EV. Methods: We...

Background: De novo hepatocellular carcinoma (HCC) complicated by pyogenic liver abscess is rare, and the standard of care for this disease has yet been defined. This study assesses whether liver resection can be recommended as its standard treatment. Methods: This retrospective study reviewed...